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Porphyria in Switzerland, 15 years experience.
[erythropoietic protoporphyria]
The
porphyrias
,
a
group
of
seven
metabolic
disorders
in
the
haem
biosynthesis
,
can
be
classified
into
acute
and
non-
acute
porphyrias
.
A
common
symptom
of
acute
porphyrias
is
severe
acute
abdominal
pain
,
whereas
cutaneous
photosensitivity
can
occur
in
both
acute
and
non-
acute
porphyrias
.
All
porphyrias
,
except
for
sporadic
porphyria
cutanea
tarda
(
sPCT
)
,
are
hereditary
disorders
caused
by
mutations
in
the
respective
genes
.
We
present
porphyria
cases
documented
in
our
porphyria
centre
during
the
past
15
years
.
Diagnosis
was
based
on
clinical
symptoms
and
biochemical
analyses
.
Mutation
analysis
was
performed
in
patients
/
families
with
a
confirmed
hereditary
porphyria
.
As
the
porphyria
specialist
centre
of
Switzerland
,
we
perform
the
specialized
analyses
required
for
the
diagnosis
of
all
types
of
porphyrias
,
and
give
advice
to
patients
,
physicians
and
other
laboratories
.
We
therefore
estimated
that
our
data
cover
80
-
90
%
of
all
diagnosed
Swiss
cases
.
A
total
of
217
patients
from
170
families
were
diagnosed
including
,
111
acute
intermittent
porphyria
,
45
erythropoietic
protoporphyria
,
30
variegate
porphyria
,
21
sPCT
,
five
congenital
erythropoietic
porphyria
,
four
hereditary
coproporphyria
and
one
hepatoerythropoietic
porphyria
patient
.
Systematic
monitoring
of
the
patients
would
allow
early
detection
of
the
potential
life-threatening
complications
such
as
hepatocellular
carcinoma
and
renal
insufficiency
in
acute
porphyrias
,
and
liver
failure
in
EPP
.
Seventy
-
five
percent
of
all
families
underwent
genetic
testing
.
Identification
of
pre-symptomatic
mutation
carriers
so
that
these
individuals
and
their
physicians
can
be
consulted
with
safety
on
drug
use
and
other
preventive
measures
,
is
important
in
managing
acute
porphyrias
.
The
unique
phenomenon
of
founder
mutations
in
the
Swiss
population
is
also
discussed
.
Diseases
Validation
Diseases presenting
"common symptom"
symptom
child syndrome
erythropoietic protoporphyria
focal myositis
liposarcoma
lymphangioleiomyomatosis
proteus syndrome
well-differentiated liposarcoma
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